The Pathway to Dominating Radiology and Imaging

The Pathway to Dominating Radiology and Imaging
Published on Diagnostic Imaging (http://www.diagnosticimaging.com)
The Pathway to Dominating Radiology and Imaging
News [1] | July 08, 2015 | Practice Management [2], Teleradiology [3]
By Tim Myers, MD [4]
A list of the major players in radiology and what radiologists should know.
Airpower and on the ground military power separately, cannot win a conflict. Together; however, the
combination can be devastating. – Anonymous.
A report from Transparency Market Research recently stated that the global teleradiology market
was worth approximately $0.92 billion in 2012. The estimation is that this market will grow at a rate
of approximately 22.3% between now and 2019, resulting in an estimated worth of approximately
$3.78 billion in 2019.
With this much money entering the market in such a short period of time, as stated in my previous
columns, the pressure to dominate the market will be irresistible for corporate and imaging players
alike; but who are the major players? As the future of radiology will potentially be determined, or at
least significantly impacted by what these groups do, radiologists should know who they are and
their strengths and focus points.
The radiology/imaging market is difficult to parse and identify a specific percentage of market
share. Not only do you have to take into account size, but also growth, visibility, and the more
ethereal quality of influence. Finally, you have account for the military dictum from above; airpower
or on-site power alone cannot win. A win in this case would be a national radiology group. This
group will need a strong and/or dominating teleradiology system supporting and supported by a
combination of local and regional on-site radiology partners who, in turn, dominate their markets.
My top picks for the four major players currently in the market include vRad/Mednax, Aris, Strategic
Radiology (SR), and Imaging Advantage (IA). There are a number of mezzanine players and a myriad
of small players also in the mix, but in my opinion, they do not have the numbers of radiologists, or
the visibility or influence required to play at the national level.
The Major Players
vRad
vRad is well known to nearly everyone in radiology and imaging. The recent purchase of vRad by
Mednax has provided additional capabilities for the future that are potentially powerful, but as of yet
unclear. The current teleradiology company is the combination of two prior industry leaders,
Nighthawk Radiology Services and Virtual Radiologic Corporation/vRad. It's hard to deny their
visibility; they have the lion’s share of offsite teleradiology services. In fact, by all estimations, they
are the world's largest provider of off-site teleradiology services. They reach all 50 states and
according to their website, they have more than 350 radiologists.
From the standpoint of combined power, vRad has attempted on-site operations with some success,
though limited. Mednax with its ability to provide a range of on-site services now includes
teleradiology; but, will this soon morph into providing on-site radiology and imaging as well? With
vRad’s knowledge base primarily centered in teleradiology, the partnership between the vRad
airpower and the Mednax ground power could be both disruptive in the market and potentially
formidable. As usual, the devil is always in the details and implementation of a complete package, if
realized, is still some distance in the future.
Technologically, vRad remains one the most aggressive radiology and imaging companies. They
continue to capitalize on their best resource – more than 15,000 interpretations per day from sites
across the United States. Data mining and turning that raw material into actionable information is a
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The Pathway to Dominating Radiology and Imaging
Published on Diagnostic Imaging (http://www.diagnosticimaging.com)
goal of the technology focus. This, along with recent collaborations, including Metamind and Scriptor
Software, to improve radiologist workflow and efficiency demonstrate that vRad is continuing to try
and move toward an even larger share of the radiology and imaging pie.
Aris
Aris is fresh from its just-completed acquisition of Optimal Radiology Partners. This deal creates a
national practice of more than 160 radiologists. It brings together an additional key component not
seen to a great extent with vRad: on-site and teleradiology services. Aris is lesser-known than vRad,
and to date has only been in the upper band of radiology companies vying for a higher profile and
more market share. With the addition of Optimal, their reach and visibility increases. The true power
and influence of the combined organizations is yet unknown. This will depend largely on what they
do next.
Strategic Radiology
Strategic Radiology (SR), with its potential power and reach, cannot be overlooked. SR began as a
concept that gained momentum and focus in 2007 when over a dozen of the largest radiology
practices in the country came to Scottsdale, Arizona for a meeting of the minds. That meeting
culminated ultimately in the formation of SR. The consortium consists of a combination of large and
moderate-sized regional radiology practices. Currently there are 18 core and 5 affiliate practices.
If size were the only determinant of who would win the game of the most dominant national
radiology group, SR representing more than 1,300 radiologists in its affiliated groups, would win
hands down. From the standpoint of visibility, however, SR remains somewhat in the background.
The primary focus, to date, according to their website, has been sharing “data and best practices,
interchanging clinical expertise, and consolidating certain practice expenses.” There is also a very
definite focus on quality and quality initiatives within the member groups.
A strong and very definite bright spot within the organization is its physician leaders, including Arl
Van Moore, Jr, MD, its Chairman and CEO. Moore was chairman of the American College of Radiology
Board of Chancellors and a past president of the American College of Radiology. He was also
president of Charlotte Radiology in Charlotte, North Carolina.
Moore says that SR is highly focused on developing a coordinated teleradiology system that will
benefit all of its members: "It takes a lot of collaboration and coordination, but we are committed to
doing it right and handling cases in a clinically and cost-efficient way, no matter how much work is
involved. Ultimately, we'll be able to provide integrated night and subspecialty final readings as well
as some locums coverage across practices."
Moore and SR have developed a progressive, visionary group of leaders and an effective board of
directors, primarily from amongst its large group partners. Together, they provide SR with the
potential to bring significant capabilities for coordination between the groups and in development of
a national, dominating radiology group. “Teamwork and leadership will be the secret to success; now
and in the future,” Moore says.
SR, whose members are radiologist-owned and run groups operated by seasoned and focused
administrative teams, stands at the opposite end of the spectrum from the mega-corporation,
Mednax/vRad. The question remains how well any one or any group of people can mold such a large
group of radiologists and radiology groups into one machine capable of sustained, coordinated
action.
Imaging Advantage
This brings us to the final player, Imaging Advantage (IA). IA was founded in 2006 by Chairman and
Chief Executive Officer Naseer Hashim. Serving with Hashim are Chief Medical Officer Art Radow,
MD, and President and Chief Operating Officer, Brian Hall, a former executive with Nighthawk
Radiology Services.
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The Pathway to Dominating Radiology and Imaging
Published on Diagnostic Imaging (http://www.diagnosticimaging.com)
Early in its history, IA had a reputation for displacing physicians and was primarily viewed as a threat
to groups concerned about losing their contracts. Today, the company focuses on aligning the
interests of physician groups and hospitals. This not only secures the local contract but provides
more options for both partners through IA’s national network of contracts. Of its new operations
effort, Hall says, "The IA solution starts with optimizing throughput and patient workflow, creating
alignment with the on-site imaging and IR physicians, the referring clinicians, and the hospital. We
augment the overall program with teleradiology and are measured on both clinical and economic
outcomes. This combination aligns well with a wide range of the new outcome and quality based
payment models."
IA has been growing. It currently reports to have over 400 radiologists with both on-site and
teleradiology operations. Its recent acquisition of BRIT Systems increases its ability to provide a
strong, unified, and proprietary RIS/PACS system, both on-site and for teleradiology. The combination
of on-site, teleradiology, and infrastructure provides a potential springboard to launch an aggressive
campaign towards a dominant position in radiology and imaging.
The Bottom Line
Whether created by radiologist-dominated or corporate-dominated groups, the first truly coordinated
national radiology group will dominate the imaging/radiology market and potentially set the course
and tone for the next 10 to 20 years. Third party payers and hospital systems alike would have to,
and may actually jump at the chance to work with such an entity.
Corporate groups like Aris are merging their way to what may be a strong foundation from which to
launch a national radiology campaign. The question is whether there is time to coordinate the new
companies and make the move to the next level.
Radiologist-dominated groups, like SR, provide a different platform, taking advantage of regional
power to dominate ever larger sections of the country. A strong, central command-and-control
governance structure with the authority to make decisions for all will allow them to be more
coordinated in their operations. An overlay of a strong teleradiology system coordinated both
centrally and regionally is the next big step needed to dominate in their respective markets and
make the entire system self-sufficient.
IA and vRad have the capital and potential power to make it to the top first. The distraction of the
recent purchase may require some time for vRad to refocus, giving IA time to continue to maneuver
and grow.
Regardless of which of these entities makes it to the top first, there is no doubt that radiologists and
radiology groups will be different and will have to learn to function in this new paradigm.
Stay tuned for more…
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Links:
[1] http://www.diagnosticimaging.com/news
[2] http://www.diagnosticimaging.com/practice-management
[3] http://www.diagnosticimaging.com/teleradiology
[4] http://www.diagnosticimaging.com/authors/tim-myers-md
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